|
HEMI CK/HK LGNSZ5-6 10MM LL/RM
|
Facility
|
OP
|
$9,685.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,259.14 |
| Max. Negotiated Rate |
$9,298.30 |
| Rate for Payer: Aetna Commercial |
$7,458.01
|
| Rate for Payer: Anthem Medicaid |
$3,330.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,554.87
|
| Rate for Payer: Cash Price |
$4,842.86
|
| Rate for Payer: Cigna Commercial |
$8,039.16
|
| Rate for Payer: First Health Commercial |
$9,201.44
|
| Rate for Payer: Humana Commercial |
$8,232.87
|
| Rate for Payer: Humana KY Medicaid |
$3,330.92
|
| Rate for Payer: Kentucky WC Medicaid |
$3,364.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,942.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,148.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,905.72
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,397.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,523.44
|
| Rate for Payer: Ohio Health Group HMO |
$7,264.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,937.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,259.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,002.58
|
| Rate for Payer: PHCS Commercial |
$9,298.30
|
| Rate for Payer: United Healthcare All Payer |
$8,523.44
|
|
|
HEMI CK/HK LGN SZ5-6 5MM LL/RM
|
Facility
|
IP
|
$9,685.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,259.14 |
| Max. Negotiated Rate |
$9,298.30 |
| Rate for Payer: Aetna Commercial |
$7,458.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,554.87
|
| Rate for Payer: Cash Price |
$4,842.86
|
| Rate for Payer: Cigna Commercial |
$8,039.16
|
| Rate for Payer: First Health Commercial |
$9,201.44
|
| Rate for Payer: Humana Commercial |
$8,232.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,942.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,148.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,905.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,523.44
|
| Rate for Payer: Ohio Health Group HMO |
$7,264.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,937.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,259.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,002.58
|
| Rate for Payer: PHCS Commercial |
$9,298.30
|
| Rate for Payer: United Healthcare All Payer |
$8,523.44
|
|
|
HEMI CK/HK LGN SZ5-6 5MM LL/RM
|
Facility
|
OP
|
$9,685.73
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,259.14 |
| Max. Negotiated Rate |
$9,298.30 |
| Rate for Payer: Aetna Commercial |
$7,458.01
|
| Rate for Payer: Anthem Medicaid |
$3,330.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,554.87
|
| Rate for Payer: Cash Price |
$4,842.86
|
| Rate for Payer: Cigna Commercial |
$8,039.16
|
| Rate for Payer: First Health Commercial |
$9,201.44
|
| Rate for Payer: Humana Commercial |
$8,232.87
|
| Rate for Payer: Humana KY Medicaid |
$3,330.92
|
| Rate for Payer: Kentucky WC Medicaid |
$3,364.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,942.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,148.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,905.72
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,397.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,523.44
|
| Rate for Payer: Ohio Health Group HMO |
$7,264.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,937.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,259.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,002.58
|
| Rate for Payer: PHCS Commercial |
$9,298.30
|
| Rate for Payer: United Healthcare All Payer |
$8,523.44
|
|
|
HEMIPHALANGECTOMY OR INTERPHALANGEAL JOINT EXCISION, TOE, PROXIMAL END OF PHALANX, EACH
|
Facility
|
OP
|
$3,918.70
|
|
|
Service Code
|
CPT 28160
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,799.07 |
| Max. Negotiated Rate |
$3,918.70 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,799.07
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$3,918.70
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,778.74
|
| Rate for Payer: Humana Medicare Advantage |
$2,799.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,358.88
|
|
|
HEMI STEP WDG G11 SZ 1-2 10
|
Facility
|
IP
|
$7,141.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$928.42 |
| Max. Negotiated Rate |
$6,856.01 |
| Rate for Payer: Aetna Commercial |
$5,499.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,570.51
|
| Rate for Payer: Cash Price |
$3,570.84
|
| Rate for Payer: Cigna Commercial |
$5,927.59
|
| Rate for Payer: First Health Commercial |
$6,784.60
|
| Rate for Payer: Humana Commercial |
$6,070.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,856.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,270.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,142.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,284.68
|
| Rate for Payer: Ohio Health Group HMO |
$5,356.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,428.34
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$928.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,213.92
|
| Rate for Payer: PHCS Commercial |
$6,856.01
|
| Rate for Payer: United Healthcare All Payer |
$6,284.68
|
|
|
HEMI STEP WDG G11 SZ 1-2 10
|
Facility
|
OP
|
$7,141.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$928.42 |
| Max. Negotiated Rate |
$6,856.01 |
| Rate for Payer: Aetna Commercial |
$5,499.09
|
| Rate for Payer: Anthem Medicaid |
$2,456.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,570.51
|
| Rate for Payer: Cash Price |
$3,570.84
|
| Rate for Payer: Cigna Commercial |
$5,927.59
|
| Rate for Payer: First Health Commercial |
$6,784.60
|
| Rate for Payer: Humana Commercial |
$6,070.43
|
| Rate for Payer: Humana KY Medicaid |
$2,456.02
|
| Rate for Payer: Kentucky WC Medicaid |
$2,481.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,856.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,270.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,142.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,505.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,284.68
|
| Rate for Payer: Ohio Health Group HMO |
$5,356.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,428.34
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$928.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,213.92
|
| Rate for Payer: PHCS Commercial |
$6,856.01
|
| Rate for Payer: United Healthcare All Payer |
$6,284.68
|
|
|
HEMI STEP WDG G11 SZ 3-4 10
|
Facility
|
OP
|
$7,141.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$928.42 |
| Max. Negotiated Rate |
$6,856.01 |
| Rate for Payer: Aetna Commercial |
$5,499.09
|
| Rate for Payer: Anthem Medicaid |
$2,456.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,570.51
|
| Rate for Payer: Cash Price |
$3,570.84
|
| Rate for Payer: Cigna Commercial |
$5,927.59
|
| Rate for Payer: First Health Commercial |
$6,784.60
|
| Rate for Payer: Humana Commercial |
$6,070.43
|
| Rate for Payer: Humana KY Medicaid |
$2,456.02
|
| Rate for Payer: Kentucky WC Medicaid |
$2,481.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,856.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,270.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,142.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,505.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,284.68
|
| Rate for Payer: Ohio Health Group HMO |
$5,356.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,428.34
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$928.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,213.92
|
| Rate for Payer: PHCS Commercial |
$6,856.01
|
| Rate for Payer: United Healthcare All Payer |
$6,284.68
|
|
|
HEMI STEP WDG G11 SZ 3-4 10
|
Facility
|
IP
|
$7,141.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$928.42 |
| Max. Negotiated Rate |
$6,856.01 |
| Rate for Payer: Aetna Commercial |
$5,499.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,570.51
|
| Rate for Payer: Cash Price |
$3,570.84
|
| Rate for Payer: Cigna Commercial |
$5,927.59
|
| Rate for Payer: First Health Commercial |
$6,784.60
|
| Rate for Payer: Humana Commercial |
$6,070.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,856.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,270.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,142.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,284.68
|
| Rate for Payer: Ohio Health Group HMO |
$5,356.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,428.34
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$928.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,213.92
|
| Rate for Payer: PHCS Commercial |
$6,856.01
|
| Rate for Payer: United Healthcare All Payer |
$6,284.68
|
|
|
HEMI STEP WDG G11 SZ 5-6 10
|
Facility
|
IP
|
$7,141.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$928.42 |
| Max. Negotiated Rate |
$6,856.01 |
| Rate for Payer: Aetna Commercial |
$5,499.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,570.51
|
| Rate for Payer: Cash Price |
$3,570.84
|
| Rate for Payer: Cigna Commercial |
$5,927.59
|
| Rate for Payer: First Health Commercial |
$6,784.60
|
| Rate for Payer: Humana Commercial |
$6,070.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,856.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,270.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,142.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,284.68
|
| Rate for Payer: Ohio Health Group HMO |
$5,356.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,428.34
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$928.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,213.92
|
| Rate for Payer: PHCS Commercial |
$6,856.01
|
| Rate for Payer: United Healthcare All Payer |
$6,284.68
|
|
|
HEMI STEP WDG G11 SZ 5-6 10
|
Facility
|
OP
|
$7,141.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$928.42 |
| Max. Negotiated Rate |
$6,856.01 |
| Rate for Payer: Aetna Commercial |
$5,499.09
|
| Rate for Payer: Anthem Medicaid |
$2,456.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,570.51
|
| Rate for Payer: Cash Price |
$3,570.84
|
| Rate for Payer: Cigna Commercial |
$5,927.59
|
| Rate for Payer: First Health Commercial |
$6,784.60
|
| Rate for Payer: Humana Commercial |
$6,070.43
|
| Rate for Payer: Humana KY Medicaid |
$2,456.02
|
| Rate for Payer: Kentucky WC Medicaid |
$2,481.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,856.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,270.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,142.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,505.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,284.68
|
| Rate for Payer: Ohio Health Group HMO |
$5,356.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,428.34
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$928.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,213.92
|
| Rate for Payer: PHCS Commercial |
$6,856.01
|
| Rate for Payer: United Healthcare All Payer |
$6,284.68
|
|
|
HEMI STEP WDG G11 SZ 7-8 10
|
Facility
|
IP
|
$7,141.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$928.42 |
| Max. Negotiated Rate |
$6,856.01 |
| Rate for Payer: Aetna Commercial |
$5,499.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,570.51
|
| Rate for Payer: Cash Price |
$3,570.84
|
| Rate for Payer: Cigna Commercial |
$5,927.59
|
| Rate for Payer: First Health Commercial |
$6,784.60
|
| Rate for Payer: Humana Commercial |
$6,070.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,856.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,270.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,142.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,284.68
|
| Rate for Payer: Ohio Health Group HMO |
$5,356.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,428.34
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$928.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,213.92
|
| Rate for Payer: PHCS Commercial |
$6,856.01
|
| Rate for Payer: United Healthcare All Payer |
$6,284.68
|
|
|
HEMI STEP WDG G11 SZ 7-8 10
|
Facility
|
OP
|
$7,141.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$928.42 |
| Max. Negotiated Rate |
$6,856.01 |
| Rate for Payer: Aetna Commercial |
$5,499.09
|
| Rate for Payer: Anthem Medicaid |
$2,456.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,570.51
|
| Rate for Payer: Cash Price |
$3,570.84
|
| Rate for Payer: Cigna Commercial |
$5,927.59
|
| Rate for Payer: First Health Commercial |
$6,784.60
|
| Rate for Payer: Humana Commercial |
$6,070.43
|
| Rate for Payer: Humana KY Medicaid |
$2,456.02
|
| Rate for Payer: Kentucky WC Medicaid |
$2,481.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,856.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,270.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,142.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,505.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,284.68
|
| Rate for Payer: Ohio Health Group HMO |
$5,356.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,428.34
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$928.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,213.92
|
| Rate for Payer: PHCS Commercial |
$6,856.01
|
| Rate for Payer: United Healthcare All Payer |
$6,284.68
|
|
|
HEMOCULT FECAL GUAIAC
|
Facility
|
OP
|
$18.00
|
|
|
Service Code
|
HCPCS 82272
|
| Hospital Charge Code |
30000252
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$17.28 |
| Rate for Payer: Aetna Commercial |
$13.86
|
| Rate for Payer: Anthem Medicaid |
$4.23
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$4.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14.45
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$5.92
|
| Rate for Payer: CareSource Just4Me Medicare |
$4.23
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna Commercial |
$14.94
|
| Rate for Payer: First Health Commercial |
$17.10
|
| Rate for Payer: Humana Commercial |
$15.30
|
| Rate for Payer: Humana KY Medicaid |
$4.23
|
| Rate for Payer: Humana Medicare Advantage |
$4.23
|
| Rate for Payer: Kentucky WC Medicaid |
$4.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$14.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5.08
|
| Rate for Payer: Molina Healthcare Medicaid |
$4.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$15.84
|
| Rate for Payer: Ohio Health Group HMO |
$13.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5.58
|
| Rate for Payer: PHCS Commercial |
$17.28
|
| Rate for Payer: United Healthcare All Payer |
$15.84
|
|
|
HEMOCULT FECAL GUAIAC
|
Facility
|
IP
|
$18.00
|
|
|
Service Code
|
HCPCS 82272
|
| Hospital Charge Code |
30000252
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$17.28 |
| Rate for Payer: Aetna Commercial |
$13.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14.45
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna Commercial |
$14.94
|
| Rate for Payer: First Health Commercial |
$17.10
|
| Rate for Payer: Humana Commercial |
$15.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$14.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$15.84
|
| Rate for Payer: Ohio Health Group HMO |
$13.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.34
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5.58
|
| Rate for Payer: PHCS Commercial |
$17.28
|
| Rate for Payer: United Healthcare All Payer |
$15.84
|
|
|
HEMOGLOBIN
|
Facility
|
OP
|
$26.00
|
|
|
Service Code
|
HCPCS 85018
|
| Hospital Charge Code |
30000568
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$24.96 |
| Rate for Payer: Aetna Commercial |
$20.02
|
| Rate for Payer: Anthem Medicaid |
$2.37
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20.88
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$3.32
|
| Rate for Payer: CareSource Just4Me Medicare |
$2.37
|
| Rate for Payer: Cash Price |
$13.00
|
| Rate for Payer: Cash Price |
$13.00
|
| Rate for Payer: Cigna Commercial |
$21.58
|
| Rate for Payer: First Health Commercial |
$24.70
|
| Rate for Payer: Humana Commercial |
$22.10
|
| Rate for Payer: Humana KY Medicaid |
$2.37
|
| Rate for Payer: Humana Medicare Advantage |
$2.37
|
| Rate for Payer: Kentucky WC Medicaid |
$2.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$2.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$22.88
|
| Rate for Payer: Ohio Health Group HMO |
$19.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8.06
|
| Rate for Payer: PHCS Commercial |
$24.96
|
| Rate for Payer: United Healthcare All Payer |
$22.88
|
|
|
HEMOGLOBIN
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS 85018
|
| Hospital Charge Code |
30000568
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1.42 |
| Max. Negotiated Rate |
$26.00 |
| Rate for Payer: Aetna Commercial |
$3.71
|
| Rate for Payer: Buckeye Medicare Advantage |
$26.00
|
| Rate for Payer: Cash Price |
$13.00
|
| Rate for Payer: Cash Price |
$13.00
|
| Rate for Payer: Cigna Commercial |
$3.45
|
| Rate for Payer: Healthspan PPO |
$2.48
|
| Rate for Payer: Multiplan PHCS |
$15.60
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$18.20
|
| Rate for Payer: UHCCP Medicaid |
$9.10
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1.42
|
|
|
HEMOGLOBIN
|
Facility
|
IP
|
$26.00
|
|
|
Service Code
|
HCPCS 85018
|
| Hospital Charge Code |
30000568
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$24.96 |
| Rate for Payer: Aetna Commercial |
$20.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20.88
|
| Rate for Payer: Cash Price |
$13.00
|
| Rate for Payer: Cigna Commercial |
$21.58
|
| Rate for Payer: First Health Commercial |
$24.70
|
| Rate for Payer: Humana Commercial |
$22.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$22.88
|
| Rate for Payer: Ohio Health Group HMO |
$19.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8.06
|
| Rate for Payer: PHCS Commercial |
$24.96
|
| Rate for Payer: United Healthcare All Payer |
$22.88
|
|
|
HEMOGLOBIN POC
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS 85018
|
| Hospital Charge Code |
30001930
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1.42 |
| Max. Negotiated Rate |
$25.00 |
| Rate for Payer: Aetna Commercial |
$3.71
|
| Rate for Payer: Buckeye Medicare Advantage |
$25.00
|
| Rate for Payer: Cash Price |
$12.50
|
| Rate for Payer: Cash Price |
$12.50
|
| Rate for Payer: Cigna Commercial |
$3.45
|
| Rate for Payer: Healthspan PPO |
$2.48
|
| Rate for Payer: Multiplan PHCS |
$15.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$17.50
|
| Rate for Payer: UHCCP Medicaid |
$8.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1.42
|
|
|
HEMOGLOBIN POC
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
HCPCS 85018
|
| Hospital Charge Code |
30001930
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Commercial |
$19.25
|
| Rate for Payer: Anthem Medicaid |
$2.37
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20.08
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$3.32
|
| Rate for Payer: CareSource Just4Me Medicare |
$2.37
|
| Rate for Payer: Cash Price |
$12.50
|
| Rate for Payer: Cash Price |
$12.50
|
| Rate for Payer: Cigna Commercial |
$20.75
|
| Rate for Payer: First Health Commercial |
$23.75
|
| Rate for Payer: Humana Commercial |
$21.25
|
| Rate for Payer: Humana KY Medicaid |
$2.37
|
| Rate for Payer: Humana Medicare Advantage |
$2.37
|
| Rate for Payer: Kentucky WC Medicaid |
$2.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$2.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$22.00
|
| Rate for Payer: Ohio Health Group HMO |
$18.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.75
|
| Rate for Payer: PHCS Commercial |
$24.00
|
| Rate for Payer: United Healthcare All Payer |
$22.00
|
|
|
HEMOGLOBIN POC
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
HCPCS 85018
|
| Hospital Charge Code |
30001930
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.25 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Commercial |
$19.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20.08
|
| Rate for Payer: Cash Price |
$12.50
|
| Rate for Payer: Cigna Commercial |
$20.75
|
| Rate for Payer: First Health Commercial |
$23.75
|
| Rate for Payer: Humana Commercial |
$21.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$22.00
|
| Rate for Payer: Ohio Health Group HMO |
$18.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.75
|
| Rate for Payer: PHCS Commercial |
$24.00
|
| Rate for Payer: United Healthcare All Payer |
$22.00
|
|
|
HEMORRHOIDECTOMY - EXT - COM
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS 46250
|
| Hospital Charge Code |
76101919
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$720.00 |
| Rate for Payer: Aetna Commercial |
$577.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$585.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$622.50
|
| Rate for Payer: First Health Commercial |
$712.50
|
| Rate for Payer: Humana Commercial |
$637.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$615.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$553.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$225.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$660.00
|
| Rate for Payer: Ohio Health Group HMO |
$562.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$150.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$97.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$232.50
|
| Rate for Payer: PHCS Commercial |
$720.00
|
| Rate for Payer: United Healthcare All Payer |
$660.00
|
|
|
HEMORRHOIDECTOMY - EXT - COM
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 46250
|
| Hospital Charge Code |
76101919
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$214.69 |
| Max. Negotiated Rate |
$750.00 |
| Rate for Payer: Aetna Commercial |
$425.83
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$221.32
|
| Rate for Payer: Anthem Medicaid |
$214.69
|
| Rate for Payer: Buckeye Medicare Advantage |
$750.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$395.83
|
| Rate for Payer: Healthspan PPO |
$493.61
|
| Rate for Payer: Humana Medicaid |
$214.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$387.22
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$218.98
|
| Rate for Payer: Molina Healthcare Passport |
$214.69
|
| Rate for Payer: Multiplan PHCS |
$450.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$525.00
|
| Rate for Payer: UHCCP Medicaid |
$232.39
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$216.84
|
|
|
HEMORRHOIDECTOMY - EXT - COM
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS 46250
|
| Hospital Charge Code |
76101919
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$3,399.27 |
| Rate for Payer: Aetna Commercial |
$577.50
|
| Rate for Payer: Anthem Medicaid |
$257.92
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,428.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$585.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$3,399.27
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,277.87
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$622.50
|
| Rate for Payer: First Health Commercial |
$712.50
|
| Rate for Payer: Humana Commercial |
$637.50
|
| Rate for Payer: Humana KY Medicaid |
$257.92
|
| Rate for Payer: Humana Medicare Advantage |
$2,428.05
|
| Rate for Payer: Kentucky WC Medicaid |
$260.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$615.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$553.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,913.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$263.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$660.00
|
| Rate for Payer: Ohio Health Group HMO |
$562.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$150.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$97.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$232.50
|
| Rate for Payer: PHCS Commercial |
$720.00
|
| Rate for Payer: United Healthcare All Payer |
$660.00
|
|
|
HEMORRHOIDECTOMY - EXT - COM(P
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 46250
|
| Hospital Charge Code |
761P1919
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$214.69 |
| Max. Negotiated Rate |
$750.00 |
| Rate for Payer: Aetna Commercial |
$425.83
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$221.32
|
| Rate for Payer: Anthem Medicaid |
$214.69
|
| Rate for Payer: Buckeye Medicare Advantage |
$750.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$395.83
|
| Rate for Payer: Healthspan PPO |
$493.61
|
| Rate for Payer: Humana Medicaid |
$214.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$387.22
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$218.98
|
| Rate for Payer: Molina Healthcare Passport |
$214.69
|
| Rate for Payer: Multiplan PHCS |
$450.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$525.00
|
| Rate for Payer: UHCCP Medicaid |
$232.39
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$216.84
|
|
|
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORE COLUMNS/GROUPS;
|
Facility
|
OP
|
$3,399.27
|
|
|
Service Code
|
CPT 46260
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,428.05 |
| Max. Negotiated Rate |
$3,399.27 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,428.05
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$3,399.27
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,277.87
|
| Rate for Payer: Humana Medicare Advantage |
$2,428.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,913.66
|
|
